Can You Recognize Pain In Your Dog?

Hello, Summarians!

Pain and quality of life are intimately related. We know that if pain is appropriately managed it can dramatically improve the joy of living. The first step is recognizing and admitting that the pain needs to be addressed. Once we accomplish those issues we can explore the different avenues that best fit a particular situation. This first study helps look at that dilemma.

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Recognizing Pain in Dogs

Recognizing and managing pain in animals is essential yet challenging in veterinary medicine. Veterinarians use various pain measurement scales, like the Canine Brief Pain Inventory and the Colorado State University Canine Acute Pain Scale (CSU-CAPS). However, they can only treat pain if the animal is brought in, which depends on the owner's ability to recognize pain through behavioral changes. Owners' ability to identify pain impacts their pets' quality of life (QOL) and the owner-pet bond. 

Most dog owners consider their pets family and want to provide the best care but often struggle to read their dog's body language. Studies show that with training, owners can detect pain through changes in their pets' behavior. This study tested whether minimal owner education on pain-related dog body language increases concern and the likelihood of seeking veterinary care. The findings confirmed that brief educational material positively impacts owners' perceptions and actions regarding their dog's pain. 

Owners' confidence in detecting pain and their attachment to their dogs significantly influenced their concern and willingness to seek care. Educational interventions can increase owners' confidence and proactive veterinary-related decisions. Common reasons for delaying veterinary care include cost, time, and stress for the pet. The study suggests incorporating flexible and accessible veterinary care options. 

Owners found tools like CSU-CAPS useful in identifying pain, deciding on veterinary visits, and communicating with veterinarians. The study supports further research on adapting veterinary pain assessment tools for owner use. In conclusion, educating owners on pain-related behaviors is key for early recognition and management of pain in dogs. Visual guides and brief educational materials can help owners better identify and respond to their dogs' pain, improving animal welfare and veterinary care compliance. 

Kogan, L. R., Currin-McCulloch, J., Brown, E., & Hellyer, P. (2024). Dog owners’ perceptions and veterinary-related decisions pertaining to changes in their dog’s behavior that could indicate pain. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.24.02.0120

Bottom line — Pain assessment tools can help owners.

Imaging Modality Can Help for Corneal Disease.

In Vivo Confocal Microscopy (IVCM) is a valuable imaging technique in veterinary ophthalmology that allows for detailed morphological and quantitative analysis of the ocular surface at the cellular level. Developed in the 1950s and adapted for ocular imaging in the 1990s, IVCM uses small apertures with a common focal point for illumination and observation, enabling only focused light to form images. This method provides high axial and lateral resolution, higher magnification, and real-time viewing. 

IVCM offers several advantages, including noninvasive, rapid imaging without the need for sedation or general anesthesia, enabling repeated examinations without significant risk. It can evaluate both superficial and deep corneal lesions. However, it has limitations such as a small field of view (300-400 µm), requiring thorough examination techniques, and dense superficial opacities that may obscure deeper layers. Examiner skill and experience are crucial for accurate image interpretation. 

Commonly used IVCM systems include Confoscan4 (Nidek Technologies) and Heidelberg Retina Tomograph II/III with Rostock Corneal Module, with the Heidelberg system providing higher resolution and better depth discrimination. The normal cornea has 10 morphologically distinct layers, and IVCM images reveal cell morphology, size, density, and reflectivity of these layers. 

IVCM has diverse clinical applications. In infectious keratitis, it enables rapid diagnosis of fungal keratitis, identifying fungal hyphae and yeast structures, and helps guide antifungal treatment and monitor response. Although limited in identifying most bacterial pathogens, IVCM can detect filamentous bacteria and biofilms associated with infectious crystalline keratopathy. In herpetic keratitis, IVCM detects morphological changes in epithelial cells, stromal nerves, and immune responses, aiding in the evaluation of chronic nerve alterations and neurotrophic keratitis. It also identifies Acanthamoeba cysts and trophozoites in parasitic infections and Onchocerca lupi in subconjunctival masses. 

IVCM visualizes microscopic corneal foreign bodies, aiding in etiological diagnosis and treatment planning. It helps discern the underlying nature of corneal deposits and opacities in corneal dystrophies and degenerations, such as lipid keratopathy, macular corneal dystrophy, and corneal endothelial dystrophy. In pigmentary keratitis, IVCM characterizes superficial epithelial, basal epithelial, and stromal pigment deposits and associated features. In corneal endotheliitis, it identifies endothelial cell abnormalities and hyperreflective deposits. 

IVCM is also useful for diagnosing and characterizing ocular surface masses, such as stromal abscesses and epithelial inclusion cysts. It evaluates corneal innervation in conditions like postherpetic neurotrophic keratitis and diabetic neuropathy, identifying morphological and functional abnormalities in corneal nerves. 

In conclusion, IVCM has rapidly expanded in veterinary ophthalmology, offering significant diagnostic and treatment advantages for various ocular surface diseases in companion animals. Continued research and new findings will further enhance its clinical applications. 

Ledbetter, E. C. (2024). Clinical applications of in vivo confocal microscopy enhance the detection and management of ocular surface disease in dogs and cats. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.24.05.0333 

Bottom line — Results support the use of this modality.

Inflammation in the Equine Intestine

Inflammatory conditions of the large intestine in horses pose significant diagnostic challenges, as current methods such as endoscopy, biopsy, and ultrasonography are limited by accessibility, delayed detection, and partial visualization. Existing fecal tests for right dorsal colitis lack sensitivity and specificity. Thus, novel diagnostic markers for intestinal inflammation in equine patients are needed. 

Fecal inflammatory biomarkers, directly resulting from intestinal inflammation, are promising for non-invasive diagnosis. In human medicine, biomarkers like myeloperoxidase (MPO) and calprotectin (CP) are used to diagnose and monitor conditions like ulcerative colitis and Crohn's disease. While MPO and CP have been linked to inflammation in horses, their diagnostic utility in equine intestinal disease remains unexplored. 

MPO, released during acute inflammation, correlates with treatment response in human inflammatory bowel diseases. In horses, elevated MPO levels are associated with various inflammatory conditions, including colic. CP, expressed by activated immune cells, accurately reflects gut inflammation in humans and correlates with neutrophil infiltration in equine colon tissues. 

The study aimed to develop reliable methods to detect MPO and CP in equine feces using commercially available ELISA kits. Initial validation using existing protocols yielded inconsistent results, leading to the evaluation of alternative sample processing methods. Fresh sample processing and the use of a custom fecal extraction buffer (FEB) improved assay reliability for CP but not for MPO. 

Despite initial challenges, the study found that CP could be reliably quantified in equine feces using the modified protocol with FEB and filtration. However, the commercially available MPO ELISA was unsuitable for fecal MPO measurement. The study highlighted the need for further research to determine the normal range of CP in healthy horses and to compare CP levels in horses with intestinal inflammation. Future work should also assess the diagnostic utility of fecal CP by comparing it to histological evidence of inflammation and expanding the study to a larger population of horses. 

In summary, this study developed a method to reliably measure CP in equine feces, suggesting its potential as a non-invasive diagnostic marker for intestinal inflammation in horses. Further research is needed to validate these findings and explore their clinical applications. 

Bishop, R. C., Graham, S. M., Connolly, S. L., Wilkins, P. A., & McCoy, A. M. (2024). Systematic evaluation supports the use of ELISA for quantification of calprotectin in equine feces, a first step toward noninvasive quantification of intestinal inflammation in horses. American Journal of Veterinary Research https://doi.org/10.2460/ajvr.24.04.011 

Bottom Line — Promising biomarker for gut inflammation in horses.

Just putting things in perspective …